Change in hepatic arterial hemodynamics induced by hepatocellular carcinoma detected with Doppler sonography

To understand the hemodynamic differences between the hepatic arterial branches that supply hepatocellular carcinomas (HCCs) and those that do not, we compared the velocity waveforms of both types of arteries.

Using duplex color Doppler sonography, we examined 38 patients with HCC localized within a single lobe of the liver and 34 patients with chronic liver disease but without HCC (controls). We measured angle-corrected peak systolic velocity and the pulsatility index (PI) of color-coded hepatic arteries along the right anterior segmental portal branch and the vertical segment of the left portal vein.

There was no significant difference in peak systolic velocity and PI between the arterial branches tested in the controls. In contrast, we found a significantly lower PI and a higher peak systolic velocity in the arterial branches supplying the tumor than in those not supplying the tumor in patients with an HCC 3 cm or larger in diameter (p < 0.05). The degree of these hemodynamic changes correlated with the tumor size and the presence or absence of tumor thrombus in the major portal branches.

These results indicate that the hepatic arterial branch supplying an HCC has a lower impedance than the branch not supplying the tumor.